Facility characteristics as independent prognostic factors of nursing home-acquired pneumonia.
- Author:
Che Wan LIM
1
;
Younghoon CHOI
;
Chang Hyeok AN
;
Sang Joon PARK
;
Hee Jin HWANG
;
Jae Ho CHUNG
;
Joo Won MIN
Author Information
- Publication Type:Comparative Study ; Original Article
- Keywords: Nursing homes; Pneumonia; Prognosis
- MeSH: Aged; Aged, 80 and over; Anti-Bacterial Agents/therapeutic use; Cause of Death; Cross Infection/diagnosis/drug therapy/microbiology/*mortality; Female; *Homes for the Aged; *Hospitals; Humans; Inappropriate Prescribing; Kaplan-Meier Estimate; Male; *Nursing Homes; Pneumonia, Bacterial/diagnosis/drug therapy/microbiology/*mortality; Proportional Hazards Models; Retrospective Studies; Risk Factors; Time Factors; Treatment Outcome
- From:The Korean Journal of Internal Medicine 2016;31(2):296-304
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Recently, the incidence of nursing home-acquired pneumonia (NHAP) has been increasing and is now the leading cause of death among nursing home residents. This study was performed to identify risk factors associated with NHAP mortality, focusing on facility characteristics. METHODS: Data on all patients > or = 70 years of age admitted with newly diagnosed pneumonia were reviewed. To compare the quality of care in nursing facilities, the following three groups were defined: patients who acquired pneumonia in the community, care homes, and care hospitals. In these patients, 90-day mortality was compared. RESULTS: Survival analyses were performed in 282 patients with pneumonia. In the analyses, 90-day mortality was higher in patients in care homes (12.2%, 40.3%, and 19.6% in community, care homes, and care hospitals, respectively). Among the 118 NHAP patients, residence in a care home, structural lung diseases, treatment with inappropriate antimicrobial agents for accompanying infections, and a high pneumonia severity index score were risk factors associated with higher 90-day mortality. However, infection by potentially drug-resistant pathogens was not important. CONCLUSIONS: Unfavorable institutional factors in care homes are important prognostic factors for NHAP.
